Dangerous New Grad Co-worker

After working as an LPN for approximately a year, within the previous year I finished nursing school and obtained my RN license. I began working at a psych facility approximately seven months ago, which has recently hired two new grad RNs that have had 3 months of training. One of the new RNs has done well and seems like he/she will blossom into a great nurse. However the other RN has not done well thus far. This person requires extensive direction, does not understand role and scope of LPN to RN duties to the point of asking LPNs if they are technically qualified to pass meds. Documentation skills are weak to the point of not documenting or obtaining an assessment on a patient readmitted into the unit after hospitalization and letting orders go un-noted and unfulfilled.

One of our residents was in resp distress last night, I responded initially and obtained V/S and asked him/her to follow me with the crash cart. She/he follows me at a very leisurely pace and simply pulls the cart up next to me. He/She does not open the cart and offer supplies, or even ask "What do you need me to do to help?" She/he continues to watch me as I am snatching the cart open and ripping out supplies to get O2 to the patient in distress as quickly as possible. I finally have to direct him/her to call for help and a medical emergency because he/she is doing nothing. The supervisor comes to help so I complete my documentation to send to the ER before the patient leaves the unit, then I walk outside and she/he is leaning against the wall helping no one. She/He is being moved to my shift and I am deeply concerned about his/her assessment skills and response to a potentially critical situation. I understand everyone must learn and no one is born with nursing knowledge and skills and maybe he/she panicked and did not know exactly what to do during an emergency. However we should all have a basic foundation that says something simple for example "Yes, you need to assess a patient returning from the hospital." She/ He will be placed on a shift and unit where she/he will be solely responsible for providing care as there is only one RN to work at night. I am sure even though I have only been at the facility for 7 months now myself I will be responsible for training him/her on nights. I am apprehensive about being involved in any potential errors made ect while this happens and concerned about the safety of our patients. Also, there is only so much I can teach someone and not do everything for them and complete the work on time that requires such extensive direction. What can I do?

tell your manager and educator if there is one but be prepared for nothing to come of it .

Jan 20, '13

I understand where you are coming from. I see many orders unchecked and I work the graveyard shift..Im talking med orders from 9am sometimes that never get faxed to pharmacy to be entered/ordered and patient doesnt receive med. I see order where doc forgot to order the freq. just wrote the drug name, dose and signed his name...well pharm. entered it as one time order but noone reported charted this med change or anything..i was livid..not like im gonna page this doc at 1am for clarification so waited until am...I could go on and on ..but I wont..Im no genius myself I have ALOT to LEARN but I do really hate stupidity and laziness.

I can say that when I first started my preceptor prob. didnt think I would make it. I took me month or so to get anywhere close being comfortable but now I am VERY comfortable..and many of the other nurses dont even know im a new nurse.

Maybe if you have ANY down time on shift go over crash cart meds supplies with him/her and encourage her to write notes on everything or can make cheat sheets for her i know i needed them for awhile.. It can be scary if it is first nursing job too I know i was terrified I would look dumb or do something wrong..praise him/her when does a good job or for effort...that can go a long way and help build confidence..let us know how it goes

Jan 21, '13

[Nice input.

QUOTE=sleepdeprived1;7130002]I understand where you are coming from. I see many orders unchecked and I work the graveyard shift..Im talking med orders from 9am sometimes that never get faxed to pharmacy to be entered/ordered and patient doesnt receive med. I see order where doc forgot to order the freq. just wrote the drug name, dose and signed his name...well pharm. entered it as one time order but noone reported charted this med change or anything..i was livid..not like im gonna page this doc at 1am for clarification so waited until am...I could go on and on ..but I wont..Im no genius myself I have ALOT to LEARN but I do really hate stupidity and laziness.

I can say that when I first started my preceptor prob. didnt think I would make it. I took me month or so to get anywhere close being comfortable but now I am VERY comfortable..and many of the other nurses dont even know im a new nurse.

Maybe if you have ANY down time on shift go over crash cart meds supplies with him/her and encourage her to write notes on everything or can make cheat sheets for her i know i needed them for awhile.. It can be scary if it is first nursing job too I know i was terrified I would look dumb or do something wrong..praise him/her when does a good job or for effort...that can go a long way and help build confidence..let us know how it goes[/QUOTE]

Jan 21, '13

In a situation like that in the future be professional and direct " Susie can you grab me a yankauer and suction set up?" It is always good after these types of situation where you can not have a real in depth conversation to perhaps follow up with.."Susie I bet you are feeling like me and have not seen a lot of emergencies such as Mrs. Blueface?" "I am so glad you were there to help me...team work is so nice" "DO you think we could have done anything differently?? I know things were moving so fast?" "Do you think we should practice ock airway emergencies??"In the case of you not thinking he/she completed things per protocol.. offer some help"hey Susie do you need help with the admission assessment on MR. IjustReturned FromtheHospital?" and follow up later and say its nice to work together are you sure that you don't need help can I doXRXRX /(insert something you know needs to be done).Also when orders are not go over them at shift change together..."wow Susie sorry you had a busy shift.. I can follow up with the Dr in the am at the end of my shift regardingxxsss(if its truly is something that can wait)..do you mind taking care of XXXX right now so I can get started on my shift???Please communicate with her/him that goes along way in building team work and fostering a new grad..you are one yourself you say? Kuddos to you.. but people come from different places and she might not (and doesn't sound like) be as far along with her organization/time management and people skills. It is always a work in progress..do NOT go to management..that just puts another layer in there and you could easily get the results you want with a little communication AND develop a great coworker relationship in the future.... you never know when you might be in his/her shoes!

Jan 23, '13

I am a new grad but i have a year of lpn experience under my belt so I don't think we are technically on the same playing field.

Very good advice, however he does not seem to be so interested in learning and correcting errors. Up until this dare he completes his shift and gets out ASAP. But I will keep this in mind for future occasions because it seems like a very professional, helpful no offensive way to approach new grads. Thanks so much.

Jan 23, '13

PP's have all offered excellent advice but I want to chime in here and URGE the OP to have "that" discussion with the unit manager. The manager is responsible for overall staff competency, but does not have extra-sensory powers to detect problems during times when s/he is not there. In my organization, we (clinical educators) are frequently called upon to help managers "diagnose" performance problems and determine the most effective corrective actions. It's pretty easy to 'fix' knowledge & skill deficits, but extremely difficult to change attitude or motivation - only the manager can do that.